Sexually transmitted infections in young people and factors associated with HIV coinfection: an observational study in a large city

Abstract

ObjectivesYoung people are a critical target group for sexually transmitted infections (STI) surveillance due to their particular behavioural and social related vulnerability. The aim of this study was to describe the epidemiological characteristics and trends in the incidence of gonorrhoea, syphilis, HIV and venereal lymphogranuloma (LGV) among 15–24-year-olds in Barcelona, and to determine factors associated with HIV coinfection.DesignWe performed a population-based incidence study covering the 2007–2015 period.ParticipantsAll new cases of STI—HIV, gonorrhoea, infectious syphilis and LGV—notified to the epidemiological surveillance system in Barcelona between 2007 and 2015. 1218 cases were studied: 84.6% were men, 19.3% were 15–19 years old and 50.6% were born in Spain. Among men, 73.7% were men who have sex with men (MSM); among women, 85.6% were women that have sex with men.Primary and secondary outcomesIncidence of HIV, gonorrhoea, infectious syphilis and LGV. HIV coinfection.ResultsThere was an increase in the incidence of gonorrhoea, from 1.9 cases per 10 000 people in 2007 to 7.6/10 000 in 2015 (p<0.01), in MSM from 27.1 to 228.8/10 000 (p<0.01). The incidence of syphilis increased from 0.4/10 000 in 2007 to 3.1/10 000 in 2015 (significant in men only, p<0.01), in MSM from 18.1 to 116.9/10 000 (p<0.01). The incidence of HIV showed a non-significant increase in men (p=0.27), and that of LGV remained stable (p=0.59). Factors associated with increased risk of HIV coinfection included being MSM (adjusted OR[ORa]=14.14, 95% CI 3.34 to 59.91) and having >10 sexual partners (ORa=4.11, 95% CI 1.53 to 11.01) or STI diagnosis during the previous 12 months (ORa=2.06; 95% CI 1.13 to 3.77).ConclusionsThe incidence of gonorrhoea and syphilis among 15–24-year-olds increased, while HIV infection remained stable but with a high incidence among MSM. Being MSM, having sex with multiple partners and having a diagnosis of an STI in the previous 12 months were factors associated with HIV coinfection.

Trends and Predictors of Sexually Transmitted Infections Among Sexually Active Ugandan Female Youths: Evidence from Three Demographic and Health Surveys, 2006-2016

“…28Both self-reported and laboratory-diagnosed STIs have been consistently high among young people with a history of having multiple lifetime partners, as seen in evidence from several studies over the years. (5,7,29,30) The results from this study equally reveal that throughout all the survey years and in the pooled dataset, female youths aged 15-24 with a history of 2 or more lifetime sex partners reported higher cases of STIs than those who reported having only one sexual partner. A study using nested health and the demographic survey also corroborates our ndings.…”

Risk factors associated with sexually transmitted infections and HIV among adolescents in a reference clinic in Madrid

“…The decline in new diagnoses between 2017 and 2018 is notable. These preliminary data suggest the decreasing trend in the incidence of HIV, as is the case in developed countries where combination HIV prevention programmes have been implemented [16]. In Spain, younger MSM could gain a greater preventive benefit by implementing new additional strategies such as preexposure prophylaxis (PrEP) [17].…”

“…All cases of HIV were detected among MSM. However, the sexual behavior has not been associated as a risk indicator for the presence of other STIs, as is the case among adults [16]. By contrast, Latin American origin was close to statistical significance as an independent factor associated with the presence of STIs, possibly relating to poor healthcare resources and insufficient sex education [24].…”

“…The data were obtained through a structured epidemiological questionnaire where information on sociodemographic, clinical and behavioural characteristics was collected: sex (men or women), age, sexual behavior (heterosexual men, men who have sex with men, women), origin (Spain, Latino America, Europe, Africa, Asia, North America), number of sexual partners year (0-5, 6-50, >50), number of sexual partners lifetime (1-10, 11-25, 26-100, >100), age of first sexual relations (�13, [14][15][16][17][18][19], type of sexual practices (oral sex, vaginal sex, insertive anal intercourse, receptive anal intercourse), frequency in the systematic use of condom (0%, <50%, �50%, 100%) or other preventive measures (post-exposure prophylaxis, pre-exposure prophylaxis), history of STIs, diagnoses of STIs at the time of first consultation (gonorrhea, chlamydia, syphilis, HIV), toxic habits (use of each drug, unprotected sexual practice that occurred under each effect: alcohol, tabacco, cannabis, cocaine, poppers, MDMA/ecstasy, ketamine, metanfetamine/crystal/tina, GHB, mephedrone), use of mobile applications in the search for sexual contacts and others (sex workers, victims of sexual abuse).…”

Efficacy of HIV interventions among factory workers in low- and middle-income countries: a systematic review

“…According to the United Nations Program on HIV/AIDS (UNAIDS) in 2016, about 36.7 million people in the world were living with HIV/AIDS, 95% of whom were from LMICs [2]. Existing studies have shown that demographic characteristics which were associated with increased risk of HIV infection included low level of education [3], labor-intensive including factory workers [4,5], and sexual orientation, such as men who have sex with men (MSM) [6]. Available data indicated that more than 44% of factory workers had less than junior high school education and more than 40% of them had two or more sex partners in one year [7][8][9][10], which meant that factory workers were at high risk of HIV infection.…”